FEC Form 1 for PENNSYLVANIA MEDICAL SOCIETY POLITICAL ACTION COMMITTEE FEDERALForm 1 for PENNSYLVANIA MEDICAL SOCIETY POLITICAL ACTION COMMITTEE FEDERAL

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-750969

1. PENNSYLVANIA MEDICAL SOCIETY POLITICAL ACTION COMMITTEE FEDERAL

PO BOX 8820
HARRISBURG, PA 17105
Email: khalk@pamedsoc.org

NOTE: Email address is different than previously reported

2. Date: 10/25/2011

3. FEC Committee ID #: C00004929 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

AMERICAN MEDICAL POLITICAL ACTION COMMITTEE
25 Massachusetts Ave NW Suite 600
WASHINGTON, DC 20001
Affiliated Relationship Code: Affiliated Committee

PENNSYLVANIA MEDICAL SOCIETY
777 EAST PARK
PO BOX 8820
HARRISBURG, Pennsylvania 171058820
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Janet Minnier
777 East Park Drive
Harrisburg, Pennsylvania 17111
Title: Treasurer
Phone # (717) 558-7750

Designated Agent(s):

Banks or Depositories

Metro Bank
4250 Derry St
Harrisburg, Pennsylvania 17111

Signed: Janet Minnier
Date Signed: 10/25/2011

(End FEC FORM 1)

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